HomeMy Public PortalAbout5016 GOLDEN WEST AVE_Mechanical__ 75AB64—CESIS-S-86 APPLICATION FOR PERMIT [�
HEATING - VENTILATING - AIR CONDITIONING Sul
COUNTY OF LOSANGELES
DEPARTMENT OF COUNTY ENGINEER B7 -
R
BUILDING AND SAFETY DIVISION A
JOHN A. LAMBIE. COUNTY ENGIINE[R
COLEMAN W. JENKINS, SUPKRINT LMDKNT OF BUILDING L
N EA EST
FOR APPLICANT TO FILL IN CROSS ST.
(Print or type only)
OWNER
No.. TYPEJOF APPLIANCE OR EQUIPMENT FEE
MAIL
A DDRESS
ABSORPTION SYSTEM, BTU CITY TEL NO.
AIR HANDLING UNIT, CFM CONTRAC R
,
BOILER, HORSEPOWER ADDRESS
COMPRESSOR, HORSEPOWER CITY TELNO.
STATE LIC.
VENTILATION SYSTEM LICENSE NG. CLASS
DISTRICT NO. GROUP ZONE PROC ED BY
EVAPORATIVE COOLER r O (`�
FURNACE: FAU GRAVITY tf
FLOOR-BTU INSPECTION REC
HEA7ER:.SUSPENDED UNIT
WALL
8
C3
W
D_
f/7
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NEW—ADDITION— PERMIT $ 3 00
ALTER--REPAIR— TOTAL FEE S
Plan check applicant
Name
Addreae
L.F
Tel. No.
HEREBY ACKXOWL[DG[ THAT I HAVE READ THIS APPLICATION STAT[ THAT THE ABOVE Il CORR[CT AXD AGRQ[ TO COMELYHALL ORDINANCE! AND LAWS REGULATING HEATING, VEXTI- APPROVALS DAT[ PECTOR S KATUR[
IMG, AIR CONOITIOXIXG.
ROUGH HEREBY CERTIFY THAT I AM NOT ACTING IN VIOLATION FINAL
CHAPT[R 0, DIVISION S, OF T BUSINESS AND PRO F[1lIOMAL[ OF TH[ STAT[ OF CALIFORJACKUR�.imALLEN,3U�PTERVISI CHANICAL ENG'R.
NATURE 'PERMI VALIDA IO 0. CASH
PERMITTEE ,
PLAN CHECK VALIDATION
8396% Fa134 .1D
SEI BACK OF APPLCATIOM FOR COM PLIETE F[[SCHEDULE v
r
I
76 A354-.CE 818-1/75
APPLICATION FOR PERMIT ,
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES AUIDRDESS /4
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY L 7'
NEAREST
CROSS ST. LA Rpf,q
FFORCE
APPLICANT TO FILL IN OWNER �, P,' ro ,-�
(PRINT OR TYPE ONLY) -
&SIZE OF EQUIPMENT FEE ADDRESS W �J
![E BACK OF APPLICATION
CITY TEL., c' 't TEL. NO. 6-I�
AIR FURNACE, BTU "� CONTRACTOR SSOR, BTU ADDRESSWe/,a 4,�ATION FAN CITY 7-e,,7e TEL. NO. VY3J-Syf 7
LIST ALL OTHERS BELOW STATE LIC. s7
LICENSE NO. Q CLASS e-+�
U131RILI NO. AROUP ZONE PROCIAlkeb
3
INSPECTION RECORD
EL
O
CJ
(r
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I-
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W
IL
Plan check fee. See reverse.
PFRWT ISSI LNG FEE S 3 00
TOTAL, FEE
PLAN CHECK A ICANT
NAME
ADDRESS
CITY TEL.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THEABOVE IS CORRTCT AND-AAREE TO COMPLY
WITH ALL ORDINANCES AND LAWB REGULATING HEATING, VENTI- APPROVALS DATE INSPSCTOA'S AIGNATUR[
LATING, AIR CONDITIONING.
RO UG H
I HEADY CERTIFYTHAT I AM HOT ACTIN[ IN IOL'.T IOJ'I
OF CHAPTER G, DIVI DIOF THE BUSINESS ND RO SSIONAL FINAL
CODE OF TyE 1TAT F ALIFOR NIA.
SIGNATURE PERMIT VALIDATION CK. M.O. CASH
OF PERMITTE
PLAN CHECK VALIDATION CK, M.O. CASH
5-50 A